Different monocytic subsets are important in inflammation and tissue remodelling, but although heart failure (HF) is associated with local and systemic inflammation, their roles in HF are yet unknown. We recruited 59 chronic systolic HF patients (aged 58 ± 13 years, 45 males and 14 females) and 29 age-matched controls with no pervious heart disease. Compared to the controls, we found no change in the distribution of the CD14+CD16+ monocytic subset, whereas the classical CD14++CD16− subset was decreased by 11% (P < 0.001), and the nonclassical CD14dimCD16+ subset was expanded by 4% (P < 0.001) in HF patients and was inversely associated with severe HF (P = 0.015), as assessed by increased end-diastolic dimension (EDD). Compared to the control group, serum TNFα, IL-1β, IL-10, and IL-13 levels were significantly elevated in the HF patients. Specifically, IL-13 levels were positively correlated to the CD1CD14dimCD16+ monocytic subset (r = 0.277, P = 0.017), and intracellular staining of IL-13 demonstrated that some of these monocytes produce the cytokine in HF patients, but not in the controls. We suggest that the inverse association between EDD values and the expansion of CD14dimCD16+ monocytes that can produce IL-13 could be explained as a measure to counterbalance adverse remodelling, which is a central process in HF.

BackgroundOral breathing is considered to increase hyper‐responsiveness of the airways. Data on the need for nose clip (NC) during exercise challenge test (ECT) in children and adolescents is scarce. Ouraim was to evaluate the role of NC during ECT in children and adolescents.MethodsA prospective, cohort study; children referred for ECT were evaluated on two separate visits, with and without a NC. Demographic, clinical data and measurements of lung functions were recorded. Allergy and asthma control were evaluated by Total Nasal Symptoms Score (TNSS) and Asthma Control Test (ACT) questionnaires.ResultsSixty children and adolescents (mean age 16.7 ± 1.1 years, 38% Female,) performed ECT with NC and 48 (80%) completed visit 2 (ECT without NC), 8.7 ± 7.9 days after visit 1. Following exercise, 29/48 patients (60.4%) with NC had a decline of ≥12% in forced expiratory volume in the first second (FEV1) (positive ECT) compared to only 16/48 (33.3%) positive tests without NC (p = 0.0008). Test result was changed in 14 patients from positive ECT (with NC) to negative ECT (no NC) and in only one patient from negative to positive. The use of NC resulted in greater FEV1 decline (median 16.3% predicted, IQR 6.0−19.1% predicted vs. median 4.5% predicted, IQR 1.6−18.4% predicted, p = 0.0001), and better FEV1 increase after bronchodil at or inhalation compared to ECT without NC. Higher TNSS scores did not predict higher probability to positive ECT.ConclusionsThe use of NC during ECT increases detection rate of exercise induced bronchoconstriction during ECT in the pediatric population. These findings strengthen the recommendation of nasal blockage during ECT in children and adolescents.

Exhaled breath condensate (EBC) collection is a non-invasive technique to obtain biosamples from the lower respiratory tract, an approach that is amenable to exercise applications. Commercially available EBC collection products exist; however, these single-use collection devices can be cost-prohibitive, and volumes are limiting in terms of the number of biomarkers that can be examined from individual samples. PURPOSE: To develop a cost-effective, reproducible methodology for obtaining larger volume EBC samples before and after exercise. METHODS: Participants (26 ± 8 yrs.) completed a 10-min collection of breathing through a novel EBC collection device (N-EBC) while seated and wearing a nose clip. After the initial sample was attained, a 45-min bout of cycling at 60% VO2max was performed, followed by a post-exercise N-EBC sample collection. In a subset of individuals (n=5), EBC was obtained using both the novel technique and a commercially available EBC collection device (R-EBC) in a randomized fashion. RESULTS: N-EBC volume pre-and post-exercise (2.3±0.8 and 2.6±0.9 mL, respectively) and pH (7.4±0.5 and 7.4±0.5, respectively) were not significantly different. No gender differences were observed (males=10; females=6) for N-EBC comparisons. When normalized for participant body height, between device comparisons indicated N-EBC volumes were 12% larger preexercise and 48% larger post-exercise. Pre-exercise pH was significantly different between the N-EBC and R-EBC trials (7.4±0.5 and 6.3±0.2, respectively; p<0.01). CONCLUSIONS:The N-EBC method produced larger sample volumes than the commercially available device, both pre-and post-exercise. N-EBC pH measures coincided with normative values for a healthy population, while R-EBC pH values were consistently outside of the normal range.